Care Coordination Measures Atlas

Background

Investigation into care coordination definitions, practices, and interventions has recently been sponsored by several national organizations including the Agency for Healthcare Research and Quality (AHRQ), the Institute of Medicine, and the American College of Physicians, among others. While evidence is starting to build about the mechanisms by which care coordination contributes to patient-centered high-value, high-quality care, the health care community is currently struggling to determine how to measure the extent to which this vital activity is or is not occurring.

An AHRQ Evidence Report1 published in 2007 demonstrated that systematic reviews of interventions to improve care coordination used a broad range of measures, with almost none that focused specifically on the structures, processes, or intermediate outcomes related to coordination. Most reports synthesized clinical and utilization measures. While these are the ultimate critical endpoints, the paucity of care-coordination-specific measurement results in limited insight about the exact mechanisms that produce better outcomes.

In response, AHRQ launched a research project with the following aim: To develop an atlas to help evaluators identify appropriate measures for assessing care coordination interventions in research studies and demonstration projects, particularly those measures focusing on care coordination in ambulatory care.

In developing this Care Coordination Measures Atlas (henceforth, the Atlas), we investigated currently available care coordination measurement approaches based on multiple data sources (e.g., electronic health record systems, consumer surveys, and databases of administrative claims), review of AHRQ Health Information Technology portfolio projects, information from national organizations on their care coordination measurement activities, input from expert and stakeholder/informant panels, and a comprehensive literature search.

The Atlas includes measures of patient and caregiver experiences with care coordination, as well as experiences of health care professionals and health system managers. To provide context to Atlas users and facilitate presentation of care coordination measurement approaches, we developed a care coordination measurement framework.